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1659789162
ELIZABETH LAKE
KENNETT SQUARE, PA
NPI
1659789162
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MD A4146)
Enumeration Date
2014-07-28
Last Update Date
2014-07-28
Business Address
Miss ELIZABETH LAKE PTA
101 E STATE ST
KENNETT SQUARE, PA 19348-3109
Phone number: 410-326-8156
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Mailing Address
Miss ELIZABETH LAKE PTA
13530 OSPREY LN P.O. BOX 209
DOWELL, MD 20629-3016
Phone number: 410-610-8251
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